No abstract available.
Animals ; Genotype* ; Heart-Lung Transplantation* ; Humans ; Mice* ; Tissue Donors*

No abstract available.
Delirium* ; Sweat* ; Sweating*

No abstract available.
Islets of Langerhans* ; Pancreas*

No abstract available.
Tetanus*

No abstract available.
Allografts* ; Anemia, Hemolytic* ; Cadaver* ; Transplantation*

No abstract available.
Leiomyosarcoma ; Vena Cava, Inferior

Over the 1 year 3 month period from 7/11/1997 until 10/30/1998, we have attempted graft salvage with tacrolimus conversion in a total of 11 patients (mean age 41 years, range 31~64 years) with ongoing rejection on baseline CsA immunosuppression after failure of high dose corticosteroid to reverse rejection. The indications for conversion to tacrolimus were ongoing biosy confirmed rejection in all patients. Seven grafts showed vascular rejection and 4 had cellular rejection on biopsy. The median interval to tacrolimus conversion was 4 days (range 1 days to 840 days) after transplantation. Three patients (27.3%) were dialysis-dependent owing to the severity of rejection. All patients (100%) have been successfully rescued and graft function of the patients improved from an average serum creatinine level of 7.3 3.6 mg/dl to 1.4 0.5 mg/dl. During the mean follow-up of 8.1 months after conversion, there were 10 complications following tacrolimus conversion including cytomegalovirus (CMV) infection in 2 patient, herpes esophagitis in 1, aspergillosis pneumonia in 1, pneumocystis carinii pneumonia in 1, new-onset diabetes mellitus in 4, tremor in 1 and bleeding due to thrombocytopenic thrombocytopenic purpura (TTP) in 1. Two of these postconversion complications resulted in patient death. Treatment with tacrolimus may successfully suppress ongoing acute rejection, even if high dose corticosteoid treatment have failed to reverse rejection. Base on these data, we recommend that tacrolimus be used for refractory rejection therapy. An additional anti-infective prophylaxis seems to be necessary in preventing severe complications after rejection therapy.
Allografts* ; Aspergillosis ; Biopsy ; Creatinine ; Cytomegalovirus ; Diabetes Mellitus ; Esophagitis ; Follow-Up Studies ; Hemorrhage ; Humans ; Immunosuppression ; Pneumonia ; Pneumonia, Pneumocystis ; Purpura, Thrombocytopenic ; Tacrolimus* ; Transplants ; Tremor

No abstract available.
Animals ; Killer Cells, Natural* ; Mice*

For patients with insulin dependent diabetes mellitus (IDDM) and renal failure from diabetic nephropathy, simultaneous pancreas-kidney transplantation(SPK) has become an accepted therapy. The benefits of pancreas transplantation are that it normalizes glucose control without the need for insulin administration, improves QOL (quality of life) of diabetic patients and prevents sequelae of hyperglycemia such as diabetic neuropathy, retinopathy and nephropathy. At present, over 1,000 cases/year of pancreas transplantation are performed worldwide, the majority in the US. Currently, there are three types of pancreas transplantation: SPK (simultaneous pancreas and kidney), PAK (pancreas after kidney), and PTA (pancreas transplantation alone). SPK transplantation is the most prevalent, representing 80~90% of the cases, but sometimes PTA is considered in the early stage of diabetic complications to prevent the progression of diabetic retinopathy. Management of surgical complications and rejection has been the key to success of pancreas transplantation. Surgical technique can be categorized according to different pancreas exocrine secretion drainage, including enteric drainage, duct injection and bladder drainage. Medications for postoperative management include antibiotics to prevent infectious disease, anticoagulants and immunosuppressants. Usually, the immunosuppressive protocol for pancreas transplantation is more aggressive than that for kidney transplantation. It is very important to closely monitor graft function for the successful outcome. Currently graft survival has been improved as around 85% of 1 yr graft survival and fairly good longterm survival. In near future islet cell transplantation will be an alternative treatment modality in DM in the condition of improved long term graft survival.
Anti-Bacterial Agents ; Anticoagulants ; Communicable Diseases ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Nephropathies ; Diabetic Neuropathies ; Diabetic Retinopathy ; Drainage ; Glucose ; Graft Survival ; Humans ; Hyperglycemia ; Immunosuppressive Agents ; Insulin ; Islets of Langerhans ; Kidney Transplantation ; Pancreas Transplantation ; Pancreas* ; Renal Insufficiency ; Transplants ; Urinary Bladder

Bcell replacement, either by the intact whole pancreas or by an isolated pancreas islet, has become a clinical option to be considered in the treatment of patients with type 1 insulindependent diabetes mellitus or some of type 2 diabetes. Between the two treatment options, the pancreas transplantation has been shown to be very effective at maintaining an euglycemic state for a sustained period of time providing the recipient with a normal life. The graft survival has been improved due to a current combination of immunosuppressants, refined surgical techniques, and a better postoperative patient care. However, it is associated with a risk of surgical and postoperative complications. The islet transplantation has been considered to be an attractive treatment modality as a less invasive and easily applicable procedure in lieu of whole organ pancreas transplantation. In spite of its many advantages, the islet transplantation has not always achieved the sustained level of normoglycemia without insulin. A poor early or long term graft survival is considered to be caused by inconsistent low islet yield, initial considerable amount of graft loss during engraftment period, rejection of islet in hepatic environment, and absence of monitoring tool for islet graft function. Although current clinical reports have led to a promising result, further improvements are needed to get the long term successful results. Now the current status of pancreas and islet transplantations is reviewed and perspectives of these treatments are discussed.
Diabetes Mellitus ; Graft Survival ; Humans ; Immunosuppressive Agents ; Insulin ; Islets of Langerhans Transplantation ; Pancreas ; Pancreas Transplantation ; Patient Care ; Postoperative Complications ; Rejection (Psychology) ; Transplants